Patterns Of Disease Prevalence Research Articles

The role of environmental variables on Aedes albopictus biology and chikungunya epidemiology

Aedes albopictus is a vector of dengue and chikungunya viruses in the field, along with around 24 additional arboviruses under laboratory conditions. As an invasive mosquito species, Ae. albopictus has been expanding in geographical range over the past 20 years, although the poleward extent of mosquito populations is limited by winter temperatures. Nonetheless, population densities depend on environmental conditions and since global climate change projections indicate increasing temperatures and altered patterns of rainfall, geographic distributions of previously tropical mosquito species may change. Although mathematical models can provide explanatory insight into observed patterns of disease prevalence in terms of epidemiological and entomological processes, understanding how environmental variables affect transmission is possible only with reliable model parameterisation, which, in turn, is obtained only through a thorough understanding of the relationship between mosquito biology and environmental variables. Thus, in order to assess the impact of climate change on mosquito population distribution and regions threatened by vector-borne disease, a detailed understanding (through a synthesis of current knowledge) of the relationship between climate, mosquito biology, and disease transmission is required, but this process has not yet been undertaken for Ae. albopictus. In this review, the impact of temperature, rainfall, and relative humidity on Ae. albopictus development and survival are considered. Existing Ae. albopictus populations across Europe are mapped with current climatic conditions, considering whether estimates of climatic cutoffs for Ae. albopictus are accurate, and suggesting that environmental thresholds must be calibrated according to the scale and resolution of climate model outputs and mosquito presence data.

Experiences of a Student Elective at McGill University

It is often debated if medical electives are beneficial for students. While medical electives are not mandatory for students in the developing world, they are an important part of medical training in some Western universities (UCSD School of Medicine, n.d.) and have been part of UK undergraduate training since the 1970s (Cruikshank & Walsh, 1980). In the West medical schools form committees to guide, counsel, and help students plan their electives during vacations. In South Asia, the concept of electives is minimally encouraged; however, the students themselves share their elective experience and encourage other students to take electives, mostly through online forums. Electives often provide students a chance to work in a different setup, with different disease prevalence patterns, hospital management protocols, and learning experiences under various doctors with diverse problem solving approaches. It is also a two pronged tool whereby students can enhance their clinical skills and find opportunities to obtain a research project under the mentorship of research oriented academic consultants. This article is a brief sketch of experiences encountered by a South Asian medical student on a clerkship elective rotation in cardiology at a tertiary care hospital in Canada.

Can Differences in Host Behavior Drive Patterns of Disease Prevalence in Tadpoles?

Differences in host behavior and resistance to disease can influence the outcome of host-pathogen interactions. We capitalized on the variation in aggregation behavior of Fowler's toads (Anaxyrus [ = Bufo] fowleri) and grey treefrogs (Hyla versicolor) tadpoles and tested for differences in transmission of Batrachochytrium dendrobatidis (Bd) and host-specific fitness consequences (i.e., life history traits that imply fitness) of infection in single-species amphibian mesocosms. On average, A. fowleri mesocosms supported higher Bd prevalences and infection intensities relative to H. versicolor mesocosms. Higher Bd prevalence in A. fowleri mesocosms may result, in part, from higher intraspecific transmission due to the aggregation of tadpoles raised in Bd treatments. We also found that, independent of species, tadpoles raised in the presence of Bd were smaller and less developed than tadpoles raised in disease-free conditions. Our results indicate that aggregation behavior might increase Bd prevalence and that A. fowleri tadpoles carry heavier infections relative to H. versicolor tadpoles. However, our results demonstrate that Bd appears to negatively impact larval growth and developmental rates of A. fowleri and H. versicolor similarly, even in the absence of high Bd prevalence.

Spatiotemporal patterns of coral disease prevalence on Heron Island, Great Barrier Reef, Australia

Despite increasing research effort on coral diseases, little is known about factors driving disease dynamics on the Great Barrier Reef (GBR). This is the first study to investigate the temporal patterns of coral disease prevalence and potential drivers of disease around Heron Island, in the southern Capricorn Bunker sector of the GBR. Surveys were conducted in two austral summers and three winters between November 2007 and August 2009 on six sites around the island. Six diseases were detected: brown band syndrome (BrB), growth anomalies (GA), ulcerative white spots (UWS), white syndrome (WS), skeletal eroding band disease (SEB) and black band disease (BBD). The lowest overall mean disease prevalence was 1.87 ± 0.75% (mean ± SE) in November 2007 and the highest 4.22 ± 1.72% in August 2008. There was evidence of seasonality for two diseases: BrB and UWS. This is the first study to report a higher prevalence of BrB in the winter. BrB had a prevalence of 3.29 ± 0.58% in August 2008 and 1.53 ± 0.28% in August 2009, while UWS was the most common syndrome in the summer with a prevalence of 1.12 ± 0.31% in November 2007 and 2.67 ± 0.52% prevalence in January 2008. The prevalence of GAs and SEB did not depend on the season, although the prevalence of GAs increased throughout the study period. WS had a slightly higher prevalence in the summer, but its overall prevalence was low (<0.5%). Sites with high abundance of staghorn Acropora and Montipora were characterised by the highest disease prevalence (12% of Acropora and 3.3% of Montipora species were diseased respectively). These results highlight the correlations between coral disease prevalence, seasonally varying environmental parameters and coral community composition. Given that diseases are likely to reduce the resilience of corals, seasonal patterns in disease prevalence deserve further research.

Coral disease in the Indian Ocean: taxonomic susceptibility, spatial distribution and the role of host density on the prevalence of white syndrome

Coral diseases, such as white diseases and white syndrome (WS), have caused widespread damage to coral reefs throughout the Caribbean and are increasing in prevalence on Pacific Ocean reefs. The current study confirms that WS is also present on coral reefs in the Indian Ocean and tests whether patterns in taxonomic susceptibility and spatial variability conform to patterns of WS reported in the Pacific Ocean. Underwater surveys at 19 sites around Christmas and Cocos Islands revealed that WS primarily affects Acropora plate corals (A. clathrata, A. cytherea and A. hyacinthus), and prevalence of WS varied significantly across all 3 spatial scales investigated (island, exposure and depth). Approximately 13.0% (range = 0 to 43% per site) of plate corals at Christmas Island sites exhibited WS compared to <1% at the Cocos Islands. At Christmas Island, WS prevalence was greater in shallow (31.5%) than in deeper water (6.7%) and greatest on the northern (leeward) side of the island (31.5%) compared to the more exposed coastlines (0 to 1.5%). Importantly, the spatial distribution of WS was positively correlated with host density, but not with hard coral cover, suggesting a role of host density in WS outbreaks. Overall the present study has established that WS is impacting remote, near-pristine reefs in the Indian Ocean. However, the highly variable spatial distribution of WS illustrates that patterns in disease prevalence, and the subsequent impact on coral reefs, can be location- or region-specific.

Changes in Caribbean coral disease prevalence after the 2005 bleaching event

Bleaching events and disease epizootics have increased during the past decades, suggesting a positive link between these 2 causes in producing coral mortality. However, studies to test this hypothesis, integrating a broad range of hierarchical spatial scales from habitats to distant localities, have not been conducted in the Caribbean. In this study, we examined links between bleaching intensity and disease prevalence collected from 6 countries, 2 reef sites for each country, and 3 habitats within each reef site (N = 6 x 2 x 3 = 36 site-habitat combinations) during the peak of bleaching in 2005 and a year after, in 2006. Patterns of disease prevalence and bleaching were significantly correlated (Rho = 0.58, p = 0.04). Higher variability in disease prevalence after bleaching occurred among habitats at each particular reef site, with a significant increase in prevalence recorded in 4 of the 10 site-habitats where bleaching was intense and a non-significant increase in disease prevalence in 18 out of the 26 site-habitats where bleaching was low to moderate. A significant linear correlation was found (r = 0.89, p = 0.008) between bleaching and the prevalence of 2 virulent diseases (yellow band disease and white plague) affecting the Montastraea species complex. Results of this study suggest that if bleaching events become more intense and frequent, disease-related mortality of Caribbean coral reef builders could increase, with uncertain effects on coral reef resilience.

Risk Factors for Abdominal Aortic Aneurysm and the Influence of Social Deprivation

the objective of this abdominal aortic aneurysm (AAA) screening study was to determine attendance and disease prevalence patterns in Northern Ireland and the role of deprivation and other risk factors. patients from primary care practices from Belfast, Lisburn, and Saintfield were screened. Past medical history and deprivation details were determined. 2264 men from Belfast, 1104 men in Lisburn, and 284 in Saintfield were invited to attend. Overall, 1659 (45.3%) men attended, with 40.6% from Belfast, 55.0% from Lisburn, and 45.8% from Saintfield (P < .0001). Ninety-two (5.5%) new AAAs were diagnosed, with 6.5%, 3.8%, and 6.2% in the 3 areas (P = .055). As deprivation decreased, attendance increased and prevalence decreased. Smoking, peripheral arterial disease, number of medications prescribed, and geographical origin were independent risk factors for AAAs. aneurysm prevalence is influenced by geographical origin and deprivation, which should, therefore, be important factors in health care planning and screening provision.

Demographic Patterns and Harvest Vulnerability of Chronic Wasting Disease Infected White-Tailed Deer in Wisconsin

Chronic wasting disease (CWD) is a fatal disease of white-tailed deer (Odocoileus virginianus) caused by transmissible protease-resistant prions. Since the discovery of CWD in southern Wisconsin in 2001, more than 20,000 deer have been removed from a >2,500-km2 disease eradication zone surrounding the three initial cases. Nearly all deer removed were tested for CWD infection and sex, age, and harvest location were recorded. Our analysis used data from a 310-km2 core study area where disease prevalence was higher than surrounding areas. We found no difference in harvest rates between CWD infected and noninfected deer. Our results show that the probability of infection increased with age and that adult males were more likely to be infected than adult females. Six fawns tested positive for CWD, five fawns from the core study area, including the youngest (5 months) free-ranging cervid to test positive. The increase in male prevalence with age is nearly twice the increase found in females. We concluded that CWD is not randomly distributed among deer and that differential transmission among sex and age classes is likely driving the observed patterns in disease prevalence. We discuss alternative hypotheses for CWD transmission and spread and, in addition, discuss several possible nonlinear relationships between prevalence and age. Understanding CWD transmission in free-ranging cervid populations will be essential to the development of strategies to manage this disease in areas where CWD is found, as well as for surveillance strategies in areas where CWD threatens to spread.

Seasonality and wildlife disease: how seasonal birth, aggregation and variation in immunity affect the dynamics of Mycoplasma gallisepticum in house finches

We examine the role of host seasonal breeding, host seasonal social aggregation and partial immunity in affecting wildlife disease dynamics, focusing on the dynamics of house finch conjunctivitis (Mycoplasma gallisepticum (MG) in Carpodacus mexicanus). This case study of an unmanaged emerging infectious disease provides useful insight into the important role of seasonal factors in driving ongoing disease dynamics. Seasonal breeding can force recurrent epidemics through the input of fresh susceptibles, which will clearly affect a wide variety of wildlife disease dynamics. Seasonal patterns of social aggregation and foraging behaviour could change transmission dynamics. We use latitudinal variation in the timing of breeding, and social systems to model seasonal dynamics of house finch conjunctivitis across eastern North America. We quantify the patterns of seasonal breeding, and social aggregation across a latitudinal gradient in the eastern range of the house finch, supplemented with known field and laboratory information on immunity to MG in finches. We then examine the interactions of these factors in a theoretical model of disease dynamics. We find that both forms of seasonality could explain the dynamics of the house finch-MG system, and that these factors could have important effects on the dynamics of wildlife diseases generally. In particular, while either alone is sufficient to create recurrent cycles of prevalence in a population with an endemic disease, both are required to produce the specific semi-annual pattern of disease prevalence seen in the house finch conjunctivitis system.

Testosterone as a modulator of vascular behavior.

Male sex is an acknowledged risk factor for many forms of cardiovascular disease, and vascular disease prevalence patterns appear to be different in men versus women. The vascular properties of the principal mammalian androgen, testosterone, are complex and linked to dose, duration of exposure, presence of underlying vascular disease, and, possibly, biological sex. Data from isolated vessels and animal models suggest that pharmacological doses of testosterone, or its potent intracellular metabolite dihydrotestosterone, produce vasodilation. Testosterone's major effect on vascular beds at physiologic concentrations remains unclear, with documentation of both vasodilatory and vasoconstrictive actions. Results of various studies suggest that testosterone can alter vascular tone through both endothelium-dependent and endothelium-independent mechanisms in a variety of vascular beds and vessel types. Testosterone's endothelium-dependent effects are likely mediated at least in part through nitric oxide (NO) elaboration, whereas mechanisms of endothelium-independent effects involve 1 or more types of smooth muscle ion conductance channels. Data from clinical studies indicate that, in men, androgen replacement may provide beneficial effects when coronary artery disease is present. Conversely, in women, testosterone may augment existing hypertension, increase risk for cardiovascular events, or promote atherogenesis. However, it should be emphasized that most of these observations are anecdotal or come from small-scale clinical studies, and limited information is available in women. New research is required to understand the potential efficacy of androgen therapy, or lack thereof. This review focuses on current understanding of testosterone's physiological effects on vascular behavior and of testosterone's putative role in vascular health and disease.

Disease and dislocation: the impact of refugee movements on the geography of malaria in NWFP, Pakistan

Studies of the health implications of refugee movements have generally focused on the effects of dislocation on the health of refugees and the impacts on health care provision at the destination. A somewhat more neglected aspect of the refugee-health research has been the impact of refugee flows on the geography of disease, i.e., how the spatial patterns of disease prevalence are modified through the influx and settlement of refugee populations. We examine this issue by examining the changing geography of malaria in Pakistan's North West Frontier Province (NWFP) between 1972 and 1997. Until the late 1970 s, the highest incidence of malaria in the region was seen in the southern and eastern parts. During the 1980 s, however, two and a half million Afghan refugees entered the NWFP and were housed in tented villages along the border and in some interior areas. As the decade progressed, there was a significant shift in the spatial pattern of malaria, with the regions of highest incidence shifting to the west and north, coinciding strongly with refugee concentrations. Our study draws attention to the manner in which refugee influx and settlement can alter the ecology of the disease system, leading to long-term changes in the geography of malaria.

The changing face of clinical laboratories.

Laboratory medicine has undergone a sea change, and medical laboratories must now adapt to, and meet new, customer-supplier needs springing from shifts in the patterns of disease prevalence, medical practice, and demographics. Managed care and other cost-containment processes have forced those involved in health care to cooperate to develop a full picture of patient care, and this has affected clinical laboratory objectives, the main focus now being on improvement in medical outcomes. More recently, the resource shortages in health care and results of cost/effectiveness analysis have demonstrated that the value of a laboratory test must be ascertained not only on the basis of its chemical or clinical performance characteristics, but also by its impact on patient management, the only true assessment of the quality of testing being quality of patient outcomes. The time is ripe for changing the vision of laboratory medicine, and some of the reasons for this are the availability of results in real-time, the introduction of more specific tests, and the trend to prevent diseases rather than cure them. The information from laboratory tests designed to evaluate biochemical or genetic risk and/or prognostic factors cannot be replaced either by physical examination and/or the assessment of symptoms. Today, the importance of laboratory scientists must be proven in three broad areas: a) guaranteeing the quality of tests, irrespective of where they are performed; b) improving the quality of the service; c) maximizing the impact of laboratory information on patient management.

Fish disease as a monitor for marine pollution: the case of the North Sea

The use of fish diseases to monitor marine pollution is reviewed and evaluated, with particular reference to the North Sea and associated waters. Criteria for epidemiological surveys are outlined, an international overview of research is given, and recent studies in the North Sea area are described and evaluated. The basic approach is to identify spatial and temporal patterns of disease prevalence, which can be related to pollution. A major obstacle is to distinguish effects of pollution from those of other variables, especially as most diseases appear to have a multifactorial aetiology. Field studies can be evaluated against a number of criteria: these include the accuracy and precision of prevalence estimates, the extent to which possible causal factors other than pollution are taken into account, and whether or not exposure of the study population to pollution is measured directly. A distinction can be made between intensive, thorough studies, which frequently use a histopathological approach, and the more extensive surveys of large numbers of fish for grossly observable lesions. Broadly speaking, North American research has emphasized the former approach, and research in the North Sea the latter. Nevertheless, although the most comprehensive evidence for a causal relationship between disease and pollution has been gathered in North America, there are also good examples from the North Sea area, particularly in local areas with distinct sources of pollution. The data from wider-ranging surveys are more ambiguous: while some provide circumstantial evidence for a role of pollution, the apparent complexity of disease aetiology and the limitations of the epidemiological approach may prevent any clear demonstration of pollution as a cause over wide geographical areas. Extensive surveys are nevertheless useful for detecting long-term trends in disease prevalence and ‘hot-spots’ of anomalously high prevalence, and for examining the relationship between disease and a complex of environmental variables. For the future, greater emphasis should be placed on the recording of liver lesions, on the measurement of exposure to pollution, and on experimental work.

Heterogeneity in disease-transmission modeling

The dynamic behavior of a family of disease models for a heterogeneous population is discussed. Asymptotic patterns of disease prevalence are related to contact and disease duration parameters for gonorrhea. Estimates show the effects of particularly infectious subgroups within a population.